Hangovers

The best treatment is prevention, by avoiding heavy alcohol use. If drinking, never drink enough to get really drunk. That way, hangovers will be rare, if not nonexistent. Not everyone is alike in such things as size, weight, metabolism, liver health and body chemistry. So, what works for one to help prevent hangovers may not work as well for another. Even when drinkers know their own tolerances and limits, hangovers seem to strike with a great deal of inconsistency. Similarly, hangover remedies seem to work with varying efficacy. This is because the hangover is actually a very complicated biological phenomenon, which is affected by widely varying factors, including the specific alcohol involved and even the drinker’s emotional state.

Contrary to popular belief, dehydration is not the only cause of hangovers. A lesser-known, but equally serious cause is congeners. Congeners are toxic chemicals that are created during the alcohol fermentation process. They give flavor, smell and appearance to alcohol and exist in varying amounts in different liquors. Unfortunately, congeners are also the main cause of the notorious hangover headache. The higher the congener content, the greater the hangover. Gin and vodka have the fewest congeners, while bourbon and red wine claim the most.

Drinking on a full stomach slows the absorption of alcohol, giving your body more of an opportunity to metabolize the alcohol without becoming overwhelmed.

This is important — don’t take aspirin, Tylenol or ibuprofen while drinking or before going to bed for the night. Acetaminophen (Tylenol) is metabolized by the liver and the combination of alcohol and acetaminophen can cause your liver to release a toxic metabolite. Alcohol mixed with acetaminophen is very dangerous and can do serious damage to your liver. Tylenol was recently forced to include warnings on its packaging telling its users not to mix it with alcohol. Ibuprofen is metabolized by your liver as well.

The remedy of having a drink the next morning does help, but also only delays the side effects temporarily. Using alcohol as a cure for alcohol sounds like it might lead to an undesirable habit, doesn’t it?

One person has reported that tomatoes taken during the recovery process, such as a glass of V8 juice, can hasten recovery. This is partially supported by the popular habit of drinking a Bloody Mary the next morning.

Risk factors for Hangovers

The most obvious source of headaches due to hangovers is dehydration caused when alcohol suppresses anti-diuretic hormone. This hormone normally orders the body to conserve water, but alcohol dulls the command, causing people to lose far more water to urination than they take in with the alcohol.

The body reacts to the open floodgates by borrowing water from other organs, such as the brain. As a result, the brain shrinks. While that may not cause pain by itself, the brain has a covering called the dura that is connected to the skull by pain-sensitive filaments. Deformation of the dura can cause the headaches that come with a hangover.

A deficiency in thiamine (vitamin B1) makes it harder for your body to break down alcohol. Interestingly, beer contains a good amount of thiamine, but as vitamin B1 oxidizes the alcohol out of the blood in the liver, thiamine is used up and must be replaced.

Acetaldehyde is a toxic substance produced in the body from alcohol and is one of the impurities found in cheap wine and ‘moonshine’ spirits. Some researchers believe that an acetaldehyde buildup is the cause of hangovers. If the liver’s detoxification pathways are impaired, aldehydes can, instead of being converted to the next intermediate product, build up to harmful levels and cause damage since they are often more toxic than the original substances from which they are derived.

It is probably the metabolism of methanol to formaldehyde and formic acid that caused the symptoms of the hangover. Quick methanol metabolizers suffer more. This is reinforced by the fact that the types of drinks associated with more severe hangovers contain higher levels of methanol. [Hangovers: Not The Ethanol, Perhaps The Methanol, British Medical Journal, January 4, 1997;14: pp.2-3]

All types of alcoholic drinks contain some methanol, a substance blamed for the worst hangovers. Whiskey, cheap red wine, fruit brandy and other dark spirits contain the most methanol, sometimes as much as 2% by volume. Vodka and other clear drinks contain the least. In the liver, methanol takes 10 times longer than ethanol to break down.

Additional water while drinking will reduce the amount of alcohol consumed and afterward will help reduce the dehydration which occurs as a result of the diuretic effect of alcohol. Dehydration plays a part in the symptoms of a hangover and the less dehydrated you are the less severe will be the symptoms. Also, being dehydrated before drinking is only going to make matters worse. So as a general rule, water before, water during, water afterwards….water always.

DMAE decreases the incidence and severity of hangovers in people who consume excessive amounts of alcohol. Subjects in one study reported freedom from the depression or headaches associated with hangovers.

A remarkable study was reported in which a group of rats were given a dose of acetaldehyde large enough to kill 90% of them. Rats given a combination of Vitamin-C, cysteine and Vitamin-B1 had no deaths. These anti-alcohol antioxidants provided 100% protection against acetaldehyde induced death. For many years, medical interns would give themselves injections of thiamine (Vitamin B1) to cure a hangover. Take a couple of 100mg thiamine tablets an hour or so before you start drinking, or sometime during the evening, then take more before bed. It may also help to take one or two the next morning.

Key

Strong or generally accepted link

May do some good

Likely to help

Highly recommended

Glossary

Metabolism

The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Stomach

A hollow, muscular, J-shaped pouch located in the upper part of the abdomen to the left of the midline. The upper end (fundus) is large and dome-shaped; the area just below the fundus is called the body of the stomach. The fundus and the body are often referred to as the cardiac portion of the stomach. The lower (pyloric) portion curves downward and to the right and includes the antrum and the pylorus. The function of the stomach is to begin digestion by physically breaking down food received from the esophagus. The tissues of the stomach wall are composed of three types of muscle fibers: circular, longitudinal and oblique. These fibers create structural elasticity and contractibility, both of which are needed for digestion. The stomach mucosa contains cells which secrete hydrochloric acid and this in turn activates the other gastric enzymes pepsin and rennin. To protect itself from being destroyed by its own enzymes, the stomach’s mucous lining must constantly regenerate itself.

Metabolite

Any product (foodstuff, intermediate, waste product) of metabolism.

Hormones

Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Magnesium

An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.

Thiamine

(Vitamin B-1): A B-complex vitamin that acts as a coenzyme necessary for the conversion of carbohydrates into glucose, which is burned in the body for energy. It is essential for the functioning of the nervous system.